Millions of people who use inhaler drugs for bronchitis and emphysema may have a higher risk of heart attacks and death according to a new study.

While the results from this study are not conclusive, doctors are being urged to closely monitor their patients that are using the inhalers. Most patients at risks have both emphysema and chronic bronchitis, but all who are taking drugs for chronic obstructive pulmonary disease (COPD) are at risk.

The drugs tiotropium (sold as Spiriva Handihaler) and ipratropium (sold as Atrovent) are used by more than 8 million people worldwide daily to relax muscles and open lung airways. The new study found that using either drug for more than one month appeared to increase chances for both fatal and non-fatal heart problems (including heart attacks) by more than 50 percent.

In about 7,400 patients on either drug, 135 people (1.8 percent) developed heart problems over a period of several weeks to several years.

While these numbers seem small, patients are urged to reduce heart risks like quitting smoking, keeping blood pressure and cholesterol under control, and using oxygen before starting the drugs.

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